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Blood cells Disorders. Leucocytosis: A raised WBCs count. Due to elevation of a single lineage. Neutophilia: Physiologic causes: Pregnancy, newborns, after parturition or after exercise. - PowerPoint PPT Presentation
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Leucocytosis:A raised WBCs count.Due to elevation of a single lineage.
Neutophilia:A) Physiologic causes:
Pregnancy, newborns, after parturition or after exercise.
B) Pathological causes:1- Infections: pyogenic bacteria.2- Neoplasia: all types.3- Hge / haemolysis.4- Corticosteroids.
Blood cells Disorders
Dr. Rania Alhady 1
Left shift:A "left shift" refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood.
A severe neutrophilia with left shift is referred to as a leukemoid reaction.
Neutophilia may be associated with the presence of toxic granulations and Dohle bodies.
Leucocytosis
Dr. Rania Alhady 2
Leucocytosis
Dr. Rania Alhady 3
Eosinophilia:Eosinophilia is a condition in which the eosinophil count in the peripheral blood exceeds 450/ cm in P.B.Causes:1- Allergic disorders
• Asthma• Drug allergies• Allergic skin diseases
2- Parasitic infections3- Some forms of malignancy
• Hodgkin's lymphoma• Some forms of Non-Hodgkin lymphoma
3- Systemic autoimmune diseases (e.g. SLE)
Monocytosis: An increase in the number of monocytes circulating in the bloodCauses: 1. Chronic inflammation: tuberculosis, syphilis and malaria2. Blood and immune causes: Myeloproliferative disorders.3. Malignancies: Certain leukaemias, such as chronic myelomonocytic leukaemia (CMML) and
monocytic leukemia.
Basophilia:Causes:• Infections: Pox virus (chicken pox, small pox)• Neoplasia: MPD (myeloproloferative disorders).
Leucocytosis
Dr. Rania Alhady 4
Lymphocytosis:Increase in the number or proportion of lymphocytes in the blood.Causes:1. Infections:- Acute viral infections: infectious mononucleosis (glandular fever), hepatitis, herpes virus, and
Cytomegalovirus infection- Acute bacterial infections: T.B., scarlet fever,
typhoid fever.- Protozoal infections: toxoplasmosis and malaria
2. Chronic lymphocytic leukemia (CLL).
3. Acute lymphoblastic leukemia (ALL). Lymphocytosis, peripheral blood smear
Leucocytosis
Dr. Rania Alhady 5
Leucopenia:Reduced total leucocytic count.
Neutropenia:Reduced neutrophil count < 2000 / cmClassification:
Classify the severity of neutropenia based on the absolute neutrophil count (ANC) measured in cells per microliter of blood:
Mild neutropenia: minimal risk of infection Moderate neutropenia: moderate risk of infection Severe neutropenia: severe risk of infection. Signs and symptoms Neutropenia can go undetected, but is generally discovered when a patient has developed severe infections or sepsis. Fevers and frequent infections. These infections can result in conditions such as mouth ulcers, diarrhea, a burning sensation during urinating, or a sore throat.
Leucopenia
Dr. Rania Alhady 6
Causes of Neutropenia:Causes can be divided into the following groups:
I. Decreased production in the bone marrow due to:• Aplastic anemia• Cancer, particularly blood cancers• Certain medications• Radiation
Blood film with a striking absence of neutrophils,
II. Increased destruction: leaving only red blood cells and platelets
• Autoimmune neutropenia: (occur with: SLE, R.A., Hodgkin disease, Felty syndrome){Felty syndrome: R.A., splenomegally, prominent neutropenia, lymphopenia}• Chemotherapy treatments, such as for cancer and autoimmune diseases
Leucopenia
Dr. Rania Alhady 7
III. Drugs induced neutopenia:Medications are very common cause of neutropenia.such a Flecainide (anti-arrhythmic drug)
Once drugs stopped, neutrophil recovery in 4 -7 days occur provided that precursors cells are normal.
IV. Congenital neutropenia syndromes:1- Kostmann‘s Syndrome:
Severe chronic neutropenia with frequent pyogenic infections. Eosinophil and basophils are normal or increased. Progression of leukemia (Very poor prognosis) Marrow transplantation may be curative.
Leucopenia
Dr. Rania Alhady 8
Leucopenia
Dr. Rania Alhady 9
2-Chediak-Higashi Syndrome: Oculocutaneous albinism
Photophobia Sun sensitivity
Neuropathy Recurrent Infections, esp Staph aureus Granules in granulocytes, monocytes and lymphocytes Treatment: BMT3- Reticular Dysgenesis: Thymic aplasia. Inability to produce neutrophil. Patient die at early age from bacterial and viral infections. BMT should be considered
Thrombocytopenia or thrombopenia :is a relative decrease of platelets in bloodSymptoms and signs:
Bruising, particularly purpura in the forearms, petechia (pinpoint hemorrhages on skin and mucous membranes), nosebleeds and/or bleeding gums.
PURPURA Defined as: -A purplish discoloration of the skin and mucous
membrane due to subcutaneous and sub mucousextravasation of blood.
-Purpura may be due to deficient and defectiveplatelets or due to an unexplained increase in capillary fragility
Thrombocytopenia
Dr. Rania Alhady 10
Causes:Increased platelets destruction:(I) Immune Thrombocytopenia:1. Auto-Abs
ITP (Immune Thrombocytopenic Purpura) 2ry to SLE & AIDS
2. Allo-Abs Post- transfusion Post- natal Post transplatation
3.Drug – induced:e.g. Quinin, sulphonamide
Thrombocytopenia
Dr. Rania Alhady 11
Thrombocytopenia
Dr. Rania Alhady 12
(II) Non – Immune Thrombocytopenia: 1. Excess platelet consumption (DIC) 2. TTP- HUS 3. Sever burn or snake venom 4. Structural platelet defects (short life span)
Immune thrombocytopenic purpura (ITP):Immune disorder characterized by: Thrombocytopenia. B.M.: normal with normal megakaryocytes in number, or even increased number with
defective budding. Evidence of Abs against platelets Spleen in NOT enlarged.
Thrombocytopenia
Dr. Rania Alhady 13
Childhood type
Adulthood type
Acute post infection Insidious Onset
Spontanous remission No spontaneous remission
Remission
Just palpable spleen(normal for age)
No enlarged spleen Spleen
Minimal bl. Loss.Good health .
Purpura, Epistaxis,menorrehia .
Clinical Picture
The same+Atypical lymphocytesEosinophilia
Decreased plat. No. Normal WBC
LaboratoryP.B.
Prolonged Prolonged B.T.
The same+ eosinophilia
Increased megas & immature forms
B.M.
Thrombocytopenia
Dr. Rania Alhady 14
Thrombotic Thrombocytopenic Purpura. Hemolytic – Uremic Syndrome:1. Idiopathic TTP-HUS:A syndrome characterized by:
1. Neurological abnormalities2. Thrombocytopenia3. Microangiopathic hemolytic anemia4. Renal involvement5. Fever
2. 2ry TTP-HUS: Causes:1. Pregnancy2. Cancer assiociated3. Drugs e.g. Cyclosporin4. Marrow Transplantation